=Paper= {{Paper |id=Vol-2391/paper39 |storemode=property |title=A technique for detecting diagnostic events in video channel of synchronous video and electroencephalographic monitoring data |pdfUrl=https://ceur-ws.org/Vol-2391/paper39.pdf |volume=Vol-2391 |authors=Dmitry Murashov,Yury Obukhov,Ivan Kershner,Mikhail Sinkin }} ==A technique for detecting diagnostic events in video channel of synchronous video and electroencephalographic monitoring data == https://ceur-ws.org/Vol-2391/paper39.pdf
A technique for detecting diagnostic events in video channel of
synchronous video and electroencephalographic monitoring
data

               D Murashov1, Yu Obukhov2, I Kershner2 and M Sinkin3

               1
                 Federal Research Center “Computer Science and Control” of Russian Academy of Sciences,
               Moscow, Russia, 119333
               2
                 Kotel'nikov Institute of Radio Engineering and Electronics of RAS, Mokhovaya str., 11-7,
               Moscow, Russia, 125009
               3
                 N.V. Sklifosovsky Research Institute for Emergency Medicine of Moscow Healthcare
               Department, Bolshaya Sukharevskaya square, 3, Moscow, Russia, 129090


               e-mail: d_murashov@mail.ru



               Abstract. In this paper, a technique for automated detecting diagnostic events in the video
               channel of video and electroencephalographic monitoring data is presented. The technique is
               based on the analysis of the quantitative features of facial expressions in images of video data.
               The analysis of video sequences is aimed at detecting a group of frames characterized by high
               activity of frame regions. For detecting the frames, a criterion computed from the optical flow
               is proposed. The preliminary results of the analysis of real clinical data are presented. The
               intervals of synchronous muscle and brain activity, which may correspond to an epileptic
               seizure, are detected. These intervals can be used for diagnosing epileptic seizures and
               distinguishing them from non-epileptic events. Requirements for video shooting conditions are
               formulated.



1. Introduction
This paper is aimed at the solution of the problem for automated detecting diagnostic events in the
video channel of synchronous video and electroencephalographic monitoring data. Video-
electroencephalographic (VEEG) monitoring is a method for long-term synchronous registration of
electroencephalography (EEG) and video image. Simultaneous video recording the clinical condition
of the patient and the bioelectric activity of the brain (i.e. EEG) allows one to diagnose epileptic
seizures reliably and distinguish them from events of non-epileptic nature [1, 2].
    The duration of EEG monitoring is usually 24 hours or more, and if used in intensive care units it
can last for weeks. Visual analysis of large amounts of data obtained during the long-term VEEG
monitoring requires huge labor costs and special training of clinical neurophysiologists. This
determines the urgency of developing new methods for detection, quantitative analysis, and
classification of diagnostic objects and the exception of artifacts in long-term VEEG monitoring of
patients.



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    The methodology of EEG analysis is traditionally based on the visual analysis of curves. Experts
identify non-artifact fragments of the record and analyze its background structure, single
(epileptiform) graph elements and their special patterns, which are specific for different clinical
conditions [3]. In most cases, the algorithmic capabilities of the software for video EEG instruments
are limited to preprocessing multi-channel EEG signals, indicating the likelihood of record artifacts,
calculating inter-channel coherence and sources of electrical activity. To simplify the assessment of
large volumes of visual information, a mathematical analysis of the oscillations with a graphical
presentation of the results, notably a quantitative EEG (qEEG), is used [4]. However, the method of
visual presentation of quantitative EEG in the form of trends and histograms does not take into
account many artifacts, in particular, chewing and movement of the patient's head. When detecting
high-amplitude plots on the qEEG histogram, the physician needs to revise the in video record a
fragment of interest for visual assessment and differentiation of an epileptic and artifact event. For this
purpose, they use not only the electrographic pattern but also the analysis of the video. In this case,
trained EEG technical and medical staff visually scanning all VEEG data and marking specific
events [2].
    Recently, a number of methods for automatic detecting seizures according to EEG data have been
proposed [3, 5-7]. However, all of them use only the native EEG without taking into account the video
image, and their accuracy is insufficient for widespread clinical practice. The analysis of publications
in periodicals and monographs in the subject domain showed the lack of publications on methods for
automatic recognition of epileptic seizures in video sequences obtained during the video-EEG
monitoring. Therefore, it is necessary to develop methods and algorithms for automated detection of
diagnostic events in long-term video-EEG recordings, which will improve the reliability of their
classification and significantly reduce the time for analyzing large amounts of video EEG data and
increase their diagnostic significance.
    In this paper, we propose a technique for detecting diagnostic events in the video channel of the
video-EEG monitoring data of patients in coma.

2. Detecting events in VEEG data
When developing a technique for automated detection of diagnostic events in VEEG data, it is
assumed that the decision on event detection is made when the specific features are detected
simultaneously in EEG and video channels. This will make it possible to avoid false alarms caused by
activity in only one of the data channels. For example, if the camera fixed the movement of a patient,
which is not associated with convulsions, or the appearance of medical staff in the frame.
   In this case, it is necessary to analyze informative areas in patient images with visible particular
muscle contractions. Informative areas are usually associated with the details of a person’s face (eyes,
nose, and mouth). Analysis of video sequences with recorded seizures showed a variety of appearance
of these seizures. For example, in the case of a non-convulsive attack, only rather weak muscular
contractions are observed in the region of the patient’s mouth. At the same time, the rest of the facial
muscles remain motionless. In another case, more intense contractions of the muscles of the mouth
and periodic movements of the head with immobile muscles in the eye area can be observed. In a
number of cases, intense contractions of the muscles are visible all over the face, and contractions of
the neck muscles and head movements are also possible. In the absence of seizures, the frames of the
video data are relatively static for the studied group of patients.
   One of the possible approaches for detecting events in a video channel can be associated with an
analysis of the dynamics of the details of a person’s face (eyes, nose, mouth). The literature presents a
wide range of methods for localizing these details [8-10]. It should be noted that the images of video
sequences obtained during VEEG monitoring have the following features. First, an arbitrary angle of
video recording the patient's face (see Figure 1). This feature eliminates methods based on the property
of facial symmetry, and methods that require a full frontal image of the face. Second, medical
equipment, partially covering the details of the face (see Figure 1(a)). This circumstance also
complicates the task of localizing diagnostically important regions. Third, informative regions may not
be associated with characteristic points of the face (eyes, corners of the mouth, etc.). Such regions, for
example, may be neck areas. Therefore, conventional methods for localization of characteristic points

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and details of the face may not be applicable. In paper [11], the authors proposed to use displacement
vectors of scene objects, which are calculated as projections of the optical flow vectors onto the floor
plane, for abnormal behavior detection in the video surveillance systems. This method has
demonstrated efficiency in a wide range of operating conditions and scenes.
    In this paper, we propose to detect diagnostic events using the magnitude of the criterion
characterizing the degree of activity of the region of interest. The region of interest will be the part of
the frame that includes the patient’s face, head, and neck areas (see Figure 1). As a criterion of the
activity of the region of interest, the total optical flow calculated for each frame of the video sequence
is used:
                                          W 1 H 1
                                   J (i)   Vx2  x, y, i   Vy2  x, y, i     i  , i  1,..., N ,   (1)
                                           x 0 y 0

where J  i  is a criterion value calculated in the frame number i ; W , H are the frame width and
height; Vx  x, y, i  and Vy  x, y, i  are the optical flow values in axial directions X and Y in the frame
number i at a pixel with coordinates  x, y  ;   i  is a noise.




                              a)                                                                  b)
                                   Figure 1. Frames from long-term VEEG records.

      Since the noise component is present in the model (1), the smoothed value of the activity criterion
 Ĵ  i  should be used to detect events. The smoothed Ĵ  i  value is obtained using a discrete version of
the Kalman-Bucy filtering algorithm [12]. We apply the Kalman-Bucy algorithm since it provides the
optimal estimate in the sense of minimum error variance. The decision to fix a diagnostic event is
made according to the threshold rule. To avoid false alarms of the detector due to short-term spikes,
the decision about the occurrence of an event is made if the value of Ĵ  i  exceeds a predetermined
threshold in a sequence of frames not shorter than M . Thus, the decision rule is formulated as follows:
                                                1, if J  i   T и i  i0  M ;
                                                      ˆ
                                        Event                                                            (2)
                                                0, if J  i   T or i  i0  M ,
                                                      ˆ
where Event is an event indicator, T is a threshold value, i0 is a frame number from which the
inequality Ĵ  i   T is taking place, M is the length of the sequence of frames required to make a
decision about the appearance of a diagnostic event. The threshold value is defined as follows:
                                                  T  Jˆ0  k ,                                  (3)
where Ĵ 0 is computed as a mean value of Ĵ  i  in a fragment of video sequence with low dynamics of
the scene,  is a standard deviation of Ĵ  i  , k is a coefficient.
   Thus, the algorithm for detecting diagnostic events in the video channel of VEEG monitoring data
consists of the following steps.
   1. Reading frame number 1 of a video sequence.


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    2. Computing the total optical flow in the region of interest in the video sequence frame according
       to the formula (1).
    3. Computing the smoothed value of the activity index Ĵ  i  .
    4. Checking conditions (2) and (3). If the condition Ĵ  i   T is satisfied, the current frame
       number i0  i is stored. If the condition is not satisfied, go to step 1.
    5. Repeating steps 1–3. If the conditions Ĵ  i   T and i  i0  M are satisfied, an event is
         detected. If not, go to step 1.
    In the next section, an experiment aimed at testing the proposed technique is described.

3. Experiment
The developed technique is implemented in the MatLab software environment. For computing
Vx  x, y, i  and Vy  x, y, i  in (1), Lucas–Kanade algorithm [13] is applied. This algorithm for
computing the optical flow is chosen from the condition of the highest performance in comparison
with other methods. The magnitude of the smoothed activity index Ĵ  i  is estimated using a discrete
version of the Kalman-Bucy filtering algorithm [12]. The values of the filtering algorithm parameters
are selected when processing test video sequences, and based on the best ratio of the error and speed
values.
    The developed technique was applied to five videos of patients in a coma. In three records epileptic
seizures are detected, including non-convulsive ones. For each of the five video sequences, the
parameters of the decision rule (2), (3) were determined from fragments with low scene dynamics. The
number of frames corresponding to the shortest event duration in condition (2) was chosen equal to 75,
which corresponds to a time interval of 2.5 seconds. The value of the coefficient in (3) was selected as
 k  1.1 . Examples of graphs of the criterion J  t  and its smoothed value Ĵ  t  , as well as the event
indicator Event for two fragments of the VEEG monitoring of the patient shown in Figure 1(a) are
given in Figures 2 and 3. Here and below, instead of the variable i designating the frame number, we
use the variable t  i / FrameRate , where t is the time, and FrameRate is the frame rate of the video.
In the experiment, we processed videos with a frame rate equal to 30 frames per second. Figure 2 (a)
demonstrates the detection of diagnostic events. For the videos, corresponding to the graphs shown in
Figures 2 (a) and 3, the parameters in expression (3) for determining the threshold value T were found
to be equal to Jˆ0  1604 and   127.9 .
    Figures 2 (b, c) show the graphs of the processed EEG signals from the synchronous recording of
VEEG monitoring. Figure 2 (b) shows the projection of the ridge of the wavelet spectrogram on the
power spectral density (PSD) and time axes. Using an adaptive threshold, the ridge points (maximum
values of the power spectral density at each time point), which lie above this threshold, were
calculated. Close points of the ridge, lying above the threshold, were combined into clusters -
fragments of the ridge, marked in black on the graph. These ridge fragments are interpreted as
episodes of suspicious activity, similar to an epileptic seizure [7].
    Figure 2 (c) shows the EEG signal in one of the channels, filtered by a Butterworth filter of the 8th
order with a passband from 5 to 22 Hz and notch filters at frequencies multiple of 50 Hz. The
sampling frequency of the signal is equal to 500 Hz. The black color indicates the suspicious intervals
obtained by analyzing the ridges of the wavelet spectrograms. From Figures 2 (a-c) one can see the
intervals of synchronous muscle and brain activity, which may correspond to epileptic seizures. These
intervals are found between 75 and 130 seconds, 144 and 147 seconds, 165 and 175 seconds, and
between 202 and 207 seconds.
    The graphs in Figure 3 correspond to video record without seizures.
    A fragment of VEEG data from another patient recorded a non-convulsive epileptic seizure. Figure
4 shows the results of processing synchronous video and EEG channels of this recording. Figure 4 (a)




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demonstrates the detection of diagnostic events in the video channel of the VEEG record. This figure
shows manifestations of seizure, which is poorly expressed, but distinguishable in Ĵ  t  graph.




                                                               a)




                                                               b)




                                                           c)
  Figure 2. Graphs obtained from VEEG monitoring data illustrating detection of diagnostic events:
(a) graphs of the criterion J  t  , estimate Ĵ  t  , and event indicator Event ; (b) projection of the ridge
 of the wavelet spectrogram on the power spectral density (PSD) and time axes; (c) EEG signal in one
           of the channels, filtered by a Butterworth filter of the 8th order and notch filters.

   Figure 4 (b) shows the projection of the ridge of the wavelet spectrogram on the power spectral
density (PSD) and time axes. Figure 4 (c) illustrates the EEG signal in one of the channels, filtered by
a Butterworth filter of the 8th order and notch filters.


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   Figure 3. Graphs of the criterion J  t  , smoothed estimate Ĵ  t  , and event indicator Event . The
                                analyzed video does not contain seizures.

   In Figures 4 (a-c) the intervals of synchronous muscle and brain activity, which may correspond to
an epileptic seizure, can be seen. These intervals are visible between 7 and 45 seconds, 50 and 53
seconds, and between 95 and 98 seconds.
   For the video, corresponding to the graphs shown in Figure 4 (a), the parameters in expression (3)
for the threshold value T were computed equal to Jˆ0  670.44 and   12.29 .
   It follows from Figures 2, 3, and 4 that diagnostic events can be detected using the criterion (1) and
the rule (2)-(3) at different angles of shooting and with partial occlusion of the patient’s face with
medical equipment.

4. Requirements for recording video data of VEEG monitoring
Requirements for recording video data of VEEG monitoring are derived from the need for reliable
detection of diagnostic events. For this, the field of view must be selected so as to provide the
necessary dynamic range of values of the criteria used for event detecting. In the field of view of the
camera should not get the details of the scene, generating a strong noise background. Essential for the
video channel is the immobility of the camera. In the video sequence captured by the unfixed camera,
the event cannot be detected due to the high level of noise in the optical flow caused by camera
movement. Camera resolution should allow fixing facial expressions and muscle contractions of small
amplitude. Based on the analysis of the video channel of the video EEG monitoring data, the following
requirements for the video shooting parameters are formulated. First, the field of view of the video
camera should cover the patient’s head and neck. Secondly, the camera should be fixed. Thirdly, the
resolution of the camera matrix should not be lower than HD.

5. Conclusions
A technique for automatic detection of diagnostic events based on the analysis of the quantitative
characteristics of the patient's activity in video records is proposed. Analysis of video sequences is
aimed at detecting a group of frames with high scene dynamics. A criterion computed from the optical
flow magnitude is applied. The preliminary results of the analysis of real clinical data for patients in a
coma are presented. The results of the analysis showed the efficiency of the proposed algorithm at
different angles of shooting and partial occlusion of the patient’s face with the details of medical
equipment. The comparison of the results of diagnostic event detection from the video record with
data obtained from the synchronous EEG showed the possibility of reliable diagnosing epileptic
seizures and distinguishing them from non-epileptic events. Future research will be aimed at applying



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pattern classifiers for detecting epileptic seizures based on a joint analysis of synchronous EEG and
video channels.




                                                               a)




                                                               b)




                                                        c)
    Figure 4. Graphs obtained from VEEG monitoring data illustrating detection of non-convulsive
 seizure: (a) graphs of the criterion J  t  , estimate Ĵ  t  , and event indicator Event ; (b) projection of
the ridge of the wavelet spectrogram on the PSD and time axes; (c) EEG signal in one of the channels,
                     filtered by a Butterworth filter of the 8th order and notch filters.

6. References
[1] Gravino G, Galea B, Soler D, Vella N and Aquilina J 2016 Video-EEG Long Term Monitoring
      as a new service at Mater Dei Hospital Malta Medical Journal 28 46-54



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[2]     Lee Y Y, Lee M Y, Chen I A, Tsai Y T, Sung C Y, Hsieh H Y and Wu T 2009 Chang Gung
        Med J 32 305-312
[3]     Hirsch L, Brenner R 2011 Atlas of EEG in critical care (John Wiley & Sons)
[4]     Duffy F H, Hughes J R, Miranda F, Bernad P and Cook P 1994 Clinical
        Electroencephalography 25 VI-XXII
[5]     Tzallas A T, Tsipouras M G and Fotiadis D I 2007 Computational Intelligence and
        Neuroscience 2007 80510
[6]     Antsiperov V E, Obukhov Y V, Komol’tsev I G and Gulyaeva N V 2017 Pattern Recognition
        and Image Analysis 27 789-803
[7]     Obukhov K, Kershner I, Komol’tsev I and Obukhov Y 2018 Pattern Recognition and Image
        Analysis 28 346-353
[8]     Yow K C and Cipolla R 1997 Image and vision computing 15 713-735
[9]     Viola P and Jones M J 2004 International journal of computer vision 57 137-154
[10]    Singh A, Patil D, Reddy M and Omkar S N 2017 Disguised face identification (DFI) with facial
        keypoints using spatial fusion convolutional network IEEE International Conference on
        Computer Vision 1648-1655
[11]    Shatalin R A, Fidelman V R, Ovchinnikov P E 2017 Abnormal behavior detection method for
        video surveillance applications Computer Optics 41(1) 37-45 DOI: 10.18287/2412-6179-2017-
        41-1-37-45
[12]    Kalman R E, Bucy R S 1961 Journal of basic engineering 83 95-108
[13]    Lucas B D, Kanade T 1981 IJCAI81 674-679

Acknowledgments
This research is partially funded by RFBR, grant № 18-29-02035.




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